Tactical Combat Casualty Care (TCCC) has been around for over 2 decades. TCCC are the training and implementation protocols for delivering trauma medicine in the tactical environment. They are the result of the US military studying the causes of death on the battlefield, finding which were preventable and developing a treatment protocol. Over the last 5 years TCCC has been adapted for civilian use and renamed Tactical Emergency Casualty Care (TECC).

This is one of the best courses you can take if you want to survive a critical incident. However, it is one nearly completely neglected by self defense enthusiasts, be they martial artists, edged weapon practitioners, or gun owners. This is largely since these self-defense pursuits often become hobbies and are practiced as a means of having fun and finding an aerobic or intellectual outlet. When these pursuits transition from “dire need for survival” to “fun” they become focused on the parts that are fun to the exclusion of the parts that are “dire need for survival”.

Walk into any Brazilian Jiu Jitsu gym and they will tell you their system is ideal for self-defense. But when you drill down into what “self-defense” is, you can see the main point has been totally lost. We won’t get into the cultural endemics of martial arts, and how the definition of a “fight” is largely what a “fight” is in the culture of origin. Be wary of imported cultural norms of fighting and self-defense.

Self Defense is avoiding death or grievous bodily harm in a violent critical incident. For our purposes now, this is interpersonal violence (but these types of injury could be sustained in a car crash or household accident). If we are worried about “Self Defense” in the context of it meaning not dying, then we should probably look at what causes death quickest and most commonly.

The TCCC research and guidelines are pretty good and give us an idea of the modern combat space (military). Here are how combat fatalities break down:Screenshot (34)

As you can see many fatalities are from untreatable injuries, such as critical CNS (Central Nervous System) injury. We are concerned only with what we can control. The TCCC manual gives us the 5 most common causes of death using the acronym “MARCH”:

Massive Bleeding

Airway Compromise

Respiratory Compromise

Circulation Compromise

Hypothermia/Head Trauma

Now Let’s look at how people are murdered in the United States. In 2014 homicide was the 17th leading cause of death in America, however it was the 3rd leading cause of death in Americans aged 15-34 (these numbers get worse for teenage minorities, where homicide is the leading cause of death for African American teens). So, we have established some baseline on the likelihood of dying by homicide. Your age, race, and geographic location all matter, but we will speak broadly.

In homicides firearms were used 68.6% of the time. So, if you get murdered it is probably going to be with a firearm. Now where will you be murdered? 51.8% of homicides (in 2014) occurred in a house or apartment, 18.6% occurred on a street or highway, 7.2% occurred in a motor vehicle, and 3.7% occurred in a parking garage or on public transport. An argument or conflict precipitated the homicide 37.9% of the time for males and 30.9% of the time for females. We can dig deep in the data and start to develop not only training methodology but prevention methodology.

Screenshot (35)

Screenshot (36)

We know that most homicides will be committed with a firearm. A firearm can cause all sorts of damage to the body, we don’t need to get into all the specifics, but it can ricochet off bone, tear through organs, sever the spine, rupture arteries and veins, etc.…

The causes of death we cannot control like CNS damage we will ignore, but MOST treatable causes of death will be from loss of blood. Exsanguination can occur rapidly, it is preceded by hypovolemic shock and loss of consciousness further tightening our window to act. The easy to follow conclusion here is that based on the data, the likely cause of your PREVENTABLE murder is a loss of blood from a gunshot wound. What are you doing to prevent this? Do you integrate these medical interventions into your self defense training? Do you carry occlusive dressings? If not, you may be fooling yourself, and if you are an instructor… fooling people who trust you with their lives.

-Alex Trafton

What Will Your Murder Look Like, And What You Can Do to Stop It: Causes of Death in The United States and the TCCC Guidelines.
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2 thoughts on “What Will Your Murder Look Like, And What You Can Do to Stop It: Causes of Death in The United States and the TCCC Guidelines.

  • July 10, 2018 at 11:01 pm

    Great stuff Alex! This is the kind of real world stuff nobody talks about or prepares for.

    • July 11, 2018 at 4:44 am

      Thanks Jack. I am dedicating some time these days to highlighting things that people do not pay attention to.


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